The Federal Communications Commission on Tuesday voted to formalize new procedures and criteria for its COVID-19 telehealth program.
The FCC is gearing up to start accepting applications for the second round of the program, which Congress established through COVID-19 relief bills. It's designed to provide healthcare organizations with funds to purchase telecommunications equipment, information-technology services and devices needed to offer telehealth services during the pandemic.
Under the Coronavirus Aid, Relief and Economic Security Act, also known as the CARES Act, Congress last year initially authorized $200 million for the FCC to set up the COVID-19 telehealth program. Congress added an additional $249.95 million to support the program as part of the Consolidated Appropriations Act of 2021 and called for increased transparency into the program.
The FCC hasn't opened applications for the program's second round yet.
Under the new procedures, the FCC will consider whether the applicant is in an area with a shortage of healthcare providers, a low-income area, a tribal community or a region hardest-hit by the COVID-19 pandemic, as well as whether the application is tied to an organization that went unfunded during the first round of the program.
The new criteria follow the FCC receiving feedback on its process for awarding COVID-19 telehealth program funding in January, as directed by Congress.
For the second round of funding, the FCC also plans to designate a specific application filing window, after which the agency will review applications. It will aim for each state and territory to have at least one organization that receives funding from the program and will award funding in two phases, so that applicants have the opportunity to provide the agency with supplemental information if they're denied funding during the first phase.
By comparison, the COVID-19 telehealth program's initial funding in 2020 was doled out on a rolling basis, with priority mainly given to organizations in COVID-19 hotspots.
In that first funding round, the FCC distributed $200 million to 539 organizations.
Lawmakers last year questioned the FCC's award process, calling on the agency to be more transparent about how it evaluated applicants.
Part of the concern arose from how the FCC distributes money to applicants. The agency doesn't directly send money to providers upon selecting their application. Instead, the FCC commits a certain amount of funding to the organization, which must later submit invoices for the FCC to reimburse—leading lawmakers to question how quickly the FCC truly distributed funds.
"We are concerned about the lack of transparency regarding this program," a bipartisan group of four lawmakers wrote in a letter to then-Chairman Ajit Pai in July, roughly two weeks after the agency awarded the final set of awards for the program's first round, noting several states did not receive any funding.
They questioned whether the FCC had "preferred speed over transparency and fairness with regard to reviewing applications."
Pai, in a response dated in January 2021, said the FCC received more than 2,000 applications from healthcare providers that the agency was unable to fund given the high demand and constraints of the $200 million budget. As of January, the FCC had distributed $119.5 million of the $200 million, as it continues to wait for providers to submit invoices, Pai wrote.
He said the FCC had targeted funding toward applications in areas hit hardest by COVID-19, using publicly available resources from the Centers for Disease Control and Prevention, Johns Hopkins University and information provided by the applicant, also considering additional factors like whether the applicant intended to use funding to support care for high-risk and vulnerable patients.
"All of these factors were considered holistically with respect to any particular application," Pai wrote in the January letter.
Telehealth has been a core priority for the FCC in recent years. The FCC late last year kicked off a $100 million pilot program to promote telehealth services, and in 2018 adopted rules to increase funding for its Rural Health Care Program, which helps rural healthcare providers purchase broadband and telecommunications services.